Technologies to Increase Freedom for People Living With Dementia

Abstract

What Is the Issue? Dementia refers to symptoms affecting cognition (including memory), behaviour, and mood, which can significantly impact daily activities and independence. Conditions that may contribute to the development of dementia include Alzheimer disease (AD), Parkinson disease, and stroke. As the population ages, the number of people in Canada living with dementia will continue to increase. More than 60% of people with dementia live at home rather than in a long-term care facility. Approximately 40% of people aged 80 and older who have dementia reside in long-term care facilities, while others stay in their homes. When living at home in the community, support is needed to maintain safety, independence, and quality of life for both the person living with dementia and their caregiver(s). Most of the assistive technologies used to help support people with dementia to live in their homes are paid for by the user and not by provincial or territorial insurance programs, highlighting issues of equity of access related to income. What Is the Technology? A variety of technologies, including medical devices and consumer electronics, are available that can be used with the intention of helping people living with dementia stay in their homes. Technologies to support the care of people living with dementia can be broadly grouped into 2 categories: technologies related to diagnosis, assessment, and early risk identification and technologies related to management and rehabilitation. This report primarily focuses on technologies that aim to provide management and rehabilitation; these aim to support people with dementia (and their caregivers) – allowing people to live in their homes and communities for longer. These are often classified as assistive devices and include GPS trackers, fall monitoring systems, and connected technologies that can increase and simplify access to services such as food or grocery delivery, pharmacies, and telehealth. What Is the Potential Impact? User-friendly, connected, and effective technologies that allow freedom for people living with dementia may also reduce caregiving stress; however, most randomized trials of assistive technologies have not demonstrated the usefulness of these technologies in real-world settings in a way that support them being formally incorporated into dementia management. The use of supportive technologies may help people living with dementia stay safely in their homes for longer, thereby reducing the burden on long-term care facilities and providing potential savings to the health care system. What Else Do We Need to Know? There is a constant conflict between safety and privacy for people living with dementia who may not always be aware of their current state of cognition and may not be able to provide adequately informed consent for the continued use of monitoring technologies. The evidence suggests further research into the effectiveness of these technologies in real-world settings is required to understand better their usefulness and place in therapy for people living at home with dementia. There remains a lack of consensus on the effectiveness of these technologies and a lack of guidance for their use.